Time to First-Line Antiretroviral Treatment Failure and its Predictors for Seropositive Children Treated in Public Hospitals, North West Ethiopia 2021

Abstract

The magnitudes of Anti-Retroviral Treatment (ART) failure for adult people living with HIV (PLWH) were exhaustively studied; however, time to treatment failure among seropositive children was overlooked, and this study aimed to assess time to first-Line Antiretroviral treatment Failure for seropositive children. Methods: Facility-based retrospective follow-up study was conducted since 1 January 2016-30 December 2020. EPI- DATA version 3.2 and STATA/14 software were used for data entry and analysis, respectively. Proportional hazard assumption was checked for each variable and no variable was found with Schoenfeld residual test <0.05. Categorical variables at bi-variables Cox regression were assessed for candidates transferred at P-value <0.25 for multivariable Cox regression to claiming predictors associated for TB incidence rate at 95% CI at P<0.005. Results: A total of 710 recorded of ART files were reviewed with 96 children (13.5%) (95% CI: 11.2, 16.3) had developed treatment failures. The overall incidence rate of treatment failure was found 4.098 (95% CI: 3.35 to 5.02) per 1000 Person Month. Children being orphaned (AHR: 4.3, 95% CI: 2.17, 7.7), WHO stage III and IV (AHR: 3.5, 95% CI: 1.8, 7.4), Poor ART adherence 3.27 (AHR:3.27, 95% CI:1.54, 4.8), ART follow-up duration ≥ 72 months (AHR: 2.28, 95% CI: 1.2, 5.2), Missed CPT 6.7 (AHR-6.7; 95% CI: 3.6, 8.4), AZT-3TC-NVP 6.5 (AHR=6.5; 95% CI: 3.2, 18.2), AZT-3TC-EFV 2.9 (AHR=2.89, 95% CI: 2.89, 10.1) were associated with treatment failures. Conclusion: Sixty-two percent of treatment failures were occurred after 72 months of ART follow up with a higher incidence of treatment failures, which is unacceptable as compared with slandered reference <10%. Being a seropositive child ≥ 70 month on ART, WHO stage III and IV, ART regiment (AZT-3TC-NVP and AZT-3TC-EFV), Poor ART adherence, missing CPT, and orphanages were associated with treatment failure.